日治時期臺灣的結核病防治政策與議論

Tuberculosis Control Policies and Discussion in Taiwan during Japanese Colonial Period

本文主妥探討日治時期臺灣總督府的結核病防治政策，由調查教據切入，再進一步說明當時醫界及衛生官員如何應對此一疾病。日治時期，因為在臺日人的結核死亡率遠低於臺人與日本國內，對在臺日人的健康無立即性的威脅，再加上日治前期臺灣總督府的疫病防治像以風土病及傳染病為要務，故至一九一五年才成立專門的收容機構。其次，從日治時期結核病防治機構的建立與法令的頒布做比較，發現日本國內已經進入以療接院對抗結核病的階段時，臺灣仍停留在病床數不足的問題上。另外從「疾孟法」和「結核預防法」的實施較日本國內延遲一、二十年亦可看出端倪。臺灣總督府至一九二O、三0年代才較積極介入結核病的防治，此與因是戰爭需求，重視人力資源的培接與強化人口素質有密切關係。再者，日治時期有關結核病致病因素的討論與防治意見，雖然一八八二年德國科學家科霍（RobertKoch）已建立「結核桿茵致病說」，但當時日本醫界對此一疾病的致病因素和防治意見仍眾說紛耘，部分人士仍強調「體質」、「遺傳」或「風土」等因素在成染結核病的過程中所扮演的重要性。在藥物治療方面並無重大突破，仍以延續生命或減緩痛苦的支持療法為主，藥物的給予也僅是症狀治療，安靜療義是當時的基本原則。最後，本文指出，即使結核病死亡率在日治時期的下降速度緩慢，但臺灣總督府的作為仍對戰後國氏政府的結核防治措施有部分的影響。

This article is aimed at analyzing the control policies and researches on tuberculosis adopted by Japanese colonial government. It also covers treatment of and prevention recommendations on tuberculosis made by doctors and health personnel. First, the article will analyze the death rate of tuberculosis for Taiwanese and Japanese residing in Taiwan during the Japanese colonial period. The analysis shows such death rate is lower for the Japanese who resided in Taiwan than the Taiwanese and the Japanese who lived in Japan. Tuberculosis did not pose a significant threat on Japanese residing in Taiwan at that time. In addition, Japanese colonial government focused on treating contagious diseases to prevent epidemics. Therefore, it was not until 1915 that designated sanitariums were established.